Call it What it is
We’ve been marinating in stress hormones for 14 months, so it's not a surprise that this week’s J & J vaccine news sent some of us into a tailspin. My female patients who actually had the J & J shot were particularly (and understandably) anxious this week.
So how do we turn off the open spigot of stress?
First, let’s put the news in perspective. Here I am on ABC 7 news talking about the J & J pause. In brief, six women developed blood clots (and tragically, one died) out of the more than 6.8 million doses of J & J vaccine administered. Causation has not been established, but if indeed this rare clotting problem is deemed a true vaccine side effect, we definitely need to know about it. We also need to realize that it is extremely rare. You are much more likely to get struck by lightning than suffer from blood clots from a vaccine like this one. You are much more likely to get a blood clot from COVID-19 itself than from any vaccine. (Forty percent of hospitalized COVID patients developed clots.)
Second, we need to realize that the FDA is looking into this issue out of an abundance of caution — as it should. This is the scientific process playing out. Whether or not they should have fully pulled the vaccine from distribution is an open question and one being hotly debated.
I see both sides. On the one hand, we need to prioritize safety and public trust in vaccines (and in the federal government). On the other hand, the side effect is so extremely rare and the devastation from COVID-19 so extremely BAD that — if I were in charge — I might have made a more nuanced decision, allowing for the vaccine to be used in patients who wanted it with informed consent about the potential for side effects.
Alas, I’m not in charge of the public health response to the pandemic. (Though I continue to Tweet every day about mental health, the vaccines, and the importance of nuanced messaging of complex medical information.)
So, for those of you who aren’t already in a full-on LATHER about the J & J news — not to mention the ongoing open display of racial injustice in this country which, to me, deserves much more attention than a couple of rare blood clots — then you’ll love today’s CNN headline: “Many millions have been vaccinated against the coronavirus; 396 were later hospitalized with Covid-19.” (The Wall Street Journal headline was a little less zippy: “CDC Identifies Small Group of Covid-19 Infections Among Fully Vaccinated Patients.”)
These articles aren’t wrong. Some vaccinated people will be and have been infected with coronavirus. Some will even get COVID-19 (the symptoms of coronavirus infection). But let’s remember the key points: vaccination essentially takes death and severe disease off the table and turns COVID-19 into a milder illness — if it causes any symptoms at all.
Remember on Monday when I suggested not to be surprised when vaccinated people get COVID? Well, here we are.
We’ve been bracing for these headlines. Let’s break this one down.
The reporting is that approximately 5,800 people out of tens of millions who have been vaccinated against coronavirus have become infected with SARS-coV-2 anyway, according to the CDC.
To be blunt, CNN’s take is terrible. I really like CNN. I love Anderson Cooper’s adorable laugh and Don Lemon’s late-night straight-talking cool-as-a-cucumber reporting. But 5,800 infections in 77,000,000? That's a 0.007% infection rate and a 0.0005% hospitalization rate — which means that 99.993% of vaccinated people have not become infected.
We really need to reframe how we’re thinking about the vaccines. They need a better PR manager—STAT. The vaccines are the CLEAR TICKET out of this hellscape, yet we seem to be framing them all wrong.
For a great graphic on the flagrant funkiness of the framing effect, check this out:
And last, to get through this time of transition, let’s name this moment. Let’s recognize what’s happening to us. Let’s understand why we’re edgy and elated, nervous and neurotic, jubilant and joyless all in the same day.
Let’s CALL IT WHAT IT IS: We are emerging from trauma.
After a year under siege, we’re at the tender intersection of fear and elation. (I wrote this piece in the Huffington Post about collective trauma a full year ago; we were already bathing in it back then.)
We have lost jobs, loved ones, and too-many-to-count life opportunities in the pandemic. The contours of our daily life have been turned upside down, our rhythms and routines tossed out the window. We face unprecedented social, political, and economic distress. And with ongoing uncertainty and risk, this is nothing short of trauma.
Of course everyone's pandemic story is different. No one’s losses or life disruptions are alike. But we’ve all experienced upheaval in some way — and to some degree. All of it matters. And if we don’t name trauma for what it is, we deprive ourselves the room to process all that is happening. We also rob ourselves of the opportunity for growth.
And on a much less sexy level, when we don't acknowledge the emotional and physical toll of accumulated stress, we can start to think we're bat-$hit crazy when we FREAK OUT about the news.
But guess what. It’s NORMAL.
If you've ever been in a car accident, you know that it's difficult to get back on the highway. If you’ve fallen off the proverbial horse, it takes guts to get back in the saddle. It’s expected to experience the “hypervigilance” — emotional and physical — after what we’ve been through.
It’s been a long 14 months, and we are far from done. Pandemics end. This one will, too. But we’ve got a long road ahead of us to restore our sense of safety and sanity. We need time to adjust and heal. We also need JOY. Let’s be kind to ourselves and allow space for recovery. We need rest, time with loved ones, laughter, and levity (when possible).
I will see you next week. Until then, be well.